Stingy GOP Governors Refuse Medicaid Expansion, Shutting Out All But Most Desperately Poor


As the Affordable Care Act gets off to a rocky start, most of the attention has been focused on the balky, web site designed for people in states that refused to create their own health care insurance exchanges, and the number of already-insured consumers whose current plans were canceled for not meeting the law’s new requirements.

Much less attention has been directed at the other major aspect of “Obamacare,” the expansion of Medicaid. There is one huge problem with that part of the law and it has nothing to do with the Obama administration, a web site or any inherent problems with the way the ACA was written.

The problem is June’s Supreme Court decision which, while to the surprise of many observers who expected the arch-conservative majority of the court to torpedo the law, actually upheld it as constitutional.

That part of the decision was great for people who previously could not obtain or afford necessary health insurance. But buried in the court’s opinion was a provision that completely undermined the new health care law — at least as it would be able to help the nation’s poorest people.

The court ruled that states were not required to participate in the Medicaid expansion part of the new law. As a result, 25 states decided to do just that: opt out. All of those states have a Republican in the governor’s mansion.

If all states took part, 17 million poor people would become eligible for Medicaid coverage who otherwise couldn’t get it. Now the number will be much lower than that.

So what does it mean if your state opts out? Well, it means that the state does not have to comply with the law’s mandated minimum income requirement to qualify for Medicaid. Under the new law, and in the 25 states that went ahead with expansion, people who make up to 138 percent of the federa poverty level will qualify for Medicaid.

In the Republican-led opt-out states, especially in states like Texas, Idaho and Alabama, you have to be absolutely dirt poor to get health coverage under Medicaid. In Texas, a parent in a family of three must not earn more than a paltry $3,737 per year in order to get Medicaid.

In Idaho, the maximum to qualify is $5,357 and in Alabama, no one who is a parent in a family of three earning more than $3,221 per year can sign pup for Medcaid.

By contrast, in states such as California, New York, Nevada, the New England states, Washington, Oregon and others that have opted in to the program, that same person could earn $26,951 — or more depending on the state — and still be eligible for Medicaid coverage.

SOURCES: Huffington Post, Washington Post


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